AB0785 ASSOCIATED FACTORS TO REMISSION IN PATIENTS WITH UVEITIS RELATED TO BEHÇET DISEASE TO THE FIRST THERAPEUTIC SCHEME
Authors: M. Cosentino, I. Gandino, C. Pena, M. C. Baretto, A. Testi, B. M. Virasoro, L. Garcia, M. Scolnik, A. Ringer, C. Siegrist, B. Abdala, S. Chulibert, M. Dalpiaz, G. Rodriguez, A. Schlaen, C. Vanegas, C. Alanez, M. Heredia, M. García
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Behcet's disease (BE) is a systemic venous and arterial vasculitis of unknown etiology [1]. Ocular involvement is common, affecting 40-70% of patients [2], and is the main cause of morbidity. Uveitis is the most frequent common ocular clinical presentation, with a prevalence that can reach up to 90% of cases, affecting the anterior and posterior segments of the eye. Among 16-25% of the cases end in blindness, so early detection and treatment are essential [3]. <h3>Objectives</h3> To describe the characteristics of uveitis in EB, extraocular manifestations, therapeutic lines used, and to compare the factors associated with uveitis remission to the first therapeutic scheme. In addition, evaluate the adherence to the EULAR 2018 recommendations. <h3>Methods</h3> Multicenter, observational, retrospective cohort study. Patients over 18 years of age with EB according to the 2014 ICBD criteria and uveitis according to the Uveitis Nomenclature Standardization Working Group (SUN). Disease remission was defined if the patient met the SUN criteria for ocular remission and if the rheumatologist did not have to change the immunosuppressant due to extraocular involvement. <h3>Results</h3> Fifty-five patients were included, 69.1% were men, with a mean age at diagnosis of 33.7 (SD 11.4) years old, mean age at uveitis presentation of 37.1 (SD 19.6) years old, and a median follow-up of 2.5 (IQR 7.2) years. HLA-b51 was positive in 13/15 (86.7%). The most frequent presentation was panuveitis (49%), bilateral (69.1%) and chronic (59.6%) affectation; the first-line treatment was azathioprine (45%). According to the variables studied, acute presentations responded better to the initial therapeutic scheme (41% vs 8.3%, p 0.01) and a history of thrombosis was associated with greater refractoriness (16.7% vs 0%, p 0.03). Table 1 shows the comparison in terms of remission or refractoriness to the first therapeutic line. In relation to the year of uveitis diagnosis, 21 cases occurred after the publication of the recommendations, and adherence to the first line was observed in 66.7%. Also, a comparison was made to find out if the physician who adhered to the EULAR recommendations had a higher probability of remission, but this was not statistically significant (66.7% vs 42.9%; p 0.99). Sequelae were observed in 11/44 patients: 1 glaucoma, 3 retinal scars, 3 blindness, and 4 cataracts. The mean visual acuity of the right eye and left eye at the first visit was 6.8 (SD 3.6) and 6.6 (SD 3.7); and in the last visit, 7.4 (DE 3.5) and 7.1 (DE 3.4), respectively. <h3>Conclusion</h3> In this multicenter cohort of patients with uveitis associated with EB, the most frequent form of presentation was panuveitis, as well as bilateral involvement and chronic forms. Approximately half of the patients achieved remission with the first therapeutic scheme line, regardless of the selected immunosuppressant. The acute forms could be associated with a higher probability of remission, while the history or presence of thrombosis would seem to be related to greater refractoriness. The therapeutic management presented high consistency with the current recommendations. <h3>References</h3> [1]Charles Jennette. J - Clin Exp Nephrol. 2013 Oct; 17(5): 603–606. [2]Ksiaa. I et al - J Fr Ophtalmol. 2019 Apr;42(4):e133-e146. [3]Zajac. H et al - J. Clin. Med. 2021, 10(21), 5174 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.